Clinical Decision Support Systems, Digital Health, Venous Thromboembolism
Conditions
Keywords
Venous Thromboembolism, Clinical Decision Support Systems, Prophylaxis
Brief summary
Venous thromboembolism (VTE) is the third leading cause of cardiovascular disease deaths globally, and its incidence is increasing over the years. Hospital-acquired VTE accounts for approximately 75% of all deaths attributed to VTE. However, only half of patients with indications for VTE prophylaxis take preventive measures, and high rates of inappropriate VTE prophylaxis prescribing contribute to the gap between VTE prophylaxis and guidelines. To further minimize the gap between clinical practice and guidelines, a range of strategies have been employed across various fields of VTE prophylaxis. One of the most effective measures is the utilization of a Clinical Decision Support System (CDSS). Smart technology-based CDSS facilitates automated evaluation of VTE risk and detection, addressing issues at both the beginning and end of the in-hospital VTE prevention process. but there is still a lack of research on how to effectively implement evidence-based VTE prophylaxis in the middle of the process. In our hospital, routine use of DeVTEcare system (a CDSS for VTE risk assessment and integrated care) for in-hospital management of VTE has been launched since 2021. This study aims to investigate the effect of integrating bundled guideline-based VTE prevention strategies into the DeVTEcare system on in-hospital VTE prophylaxis.
Interventions
OTHERApplication of the modified DeVTEcare system
The modified DeVTEcare system, which incorporates bundled guideline-based VTE prevention measures, will be utilized to assist healthcare providers in VTE prophylaxis after September 2024.
Sponsors
Navy General Hospital, Beijing
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Discharged patients who were ≥18 years of age at admission were included in the observation cohort. If a patient had multiple hospitalizations, information on only the longest hospitalization was included in the study.
Exclusion criteria
* Lack of diagnostic information； * Length of hospitalization ≤ 24 hours； * Patients on anticoagulation therapy at the time of admission: e.g., those with established VTE, atrial fibrillation, acute myocardial infarction, ischemic stroke, those on continuous renal replacement therapy, extracorporeal membrane pulmonary oxygenation, hemodialysis, and mechanical valve implantation status.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| In-hospital VTE | During the hospitalization (assessed up to 30 days) | In-hospital VTE refers to the occurrence of a VTE in a patient who did not have a VTE on admission but developed one during the course of their hospital stay. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Guideline-compliant prescription of VTE prophylaxis | During the hospitalization (assessed up to 30 days) | Guideline-compliant prescription of VTE prophylaxis refers to the adoption of risk stratification to guide clinicians' decisions to prescribe guideline recommended thromboprophylaxis. |
| Preventable VTE | During the hospitalization (assessed up to 30 days) | Preventable VTE is defined as occurring in a high-risk patient not prescribed adequate VTE prophylaxis. |
| Hospital-related VTE death | During the hospitalization (assessed up to 30 days) | Hospital-related VTE death is defined as patient who died during the present hospitalization while having an in-hospital VTE event. |
| Major bleeding | During the hospitalization (assessed up to 30 days) | The major bleeding events are defined by the International Society on Thrombosis and Hemostasis (ISTH) and are further categorized into VTE prophylaxis-related major bleeding and VTE treatment-related major bleeding. |
| Non-major bleeding | During the hospitalization (assessed up to 30 days) | The non-major bleeding events are defined by the International Society on Thrombosis and Hemostasis (ISTH) and are further categorized into VTE prophylaxis-related non-major bleeding and VTE treatment-related non-major bleeding. |
Contacts
Primary ContactZHI-GENG JIN, Doctor
Outcome results
None listed